Outpatient antibiotic use is closely related to antimicrobial resistance and in Germany, almost 70% of antibiotic prescriptions in human health are issued by primary care physicians (PCPs). The aim of this study was to explore PCPs, namely General Practitioners’ (GPs) and outpatient pediatricians’ (PDs) knowledge of guideline recommendations on rational antimicrobial treatment, the determinants of confidence in treatment decisions and the perceived need for training in this topic in a large sample of PCPs from southern Germany. Out of 3753 reachable PCPs, 1311 completed the survey (overall response rate = 34.9%). Knowledge of guideline recommendations and perceived confidence in making treatment decisions were high in both GPs and PDs. The two highest rated influencing factors on prescribing decisions were reported to be guideline recommendations and own clinical experiences, hence patients’ demands and expectations were judged as not influencing treatment decisions. The majority of physicians declared to have attended at least one specific training course on antibiotic use, yet almost all the participating PCPs declared to need more training on this topic. More studies are needed to explore how consultation-related and context-specific factors could influence antibiotic prescriptions in general and pediatric primary care in Germany beyond knowledge. Moreover, efforts should be undertaken to explore the training needs of PCPs in Germany, as this would serve the development of evidence-based educational interventions targeted to the improvement of antibiotic prescribing decisions rather than being focused solely on knowledge of guidelines.

中文翻译：

---

德国初级保健中常见感染的管理：全科医生和门诊儿科医生知识和信心的横断面调查

门诊抗生素的使用与抗菌素耐药性密切相关，在德国，人类健康中近 70% 的抗生素处方是由初级保健医生 (PCP) 开具的。本研究的目的是探索 PCP，即全科医生 (GP) 和门诊儿科医生 (PD) 对合理抗菌治疗指南建议的了解、对治疗决策的信心的决定因素以及对本主题培训的感知需求来自德国南部的大量 PCP 样本。在 3753 个可访问的 PCP 中，1311 个完成了调查（总体响应率 = 34.9%）。GP 和 PD 对指南建议的了解和对治疗决策的信心都很高。据报道，影响处方决策的两个最高影响因素是指南建议和自己的临床经验，因此判断患者的需求和期望不影响治疗决策。大多数医生声称至少参加了一个抗生素使用的特定培训课程，但几乎所有参与的 PCP 都声称需要更多关于该主题的培训。需要更多的研究来探索与咨询相关和特定背景的因素如何影响德国一般和儿科初级保健中的抗生素处方。此外，应努力探索德国 PCP 的培训需求，